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维生素 D 补充剂在健康中年人群中的应用:基于法国全面区域医疗保健数据库数据的实际做法。

Vitamin D supplementation in a healthy, middle-aged population: actual practices based on data from a French comprehensive regional health-care database.

机构信息

1] Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Unité d'Epidémiologie, Lyon, France [2] Inserm U INSERM 1033 Pavillon F, Service de Rhumatologie and de Pathologie Osseuse, Immunologie Clinique Cancérologie Osseuse, Lyon, France.

出版信息

Eur J Clin Nutr. 2013 Nov;67(11):1133-7. doi: 10.1038/ejcn.2013.182. Epub 2013 Oct 2.

Abstract

BACKGROUND/OBJECTIVES: The debate surrounding recommendations for vitamin D supplementation in middle-aged patients (that is, 20-60 years of age) with low serum concentrations of 25-hydroxyvitamin D (25(OH)D) is growing. Our aim was to describe practices regarding vitamin D supplementation in this age group, which are basically unknown.

SUBJECTS/METHODS: We performed an analysis using exhaustive reimbursement data from the individuals in Rhône-Alpes area, a French region regrouping more than 6 million of inhabitants. The data were collected from the French Insurance Health-care System. Patients who were 20-60 years of age, had no severe comorbidities, had a 25(OH)D assay between 1 December 2008 and 31 January 2009 were identified. Those who received a subsequent prescription for vitamin D were included in this analysis. We described patterns of vitamin D supplementation by frequency and daily dose.

RESULTS

The sample in this study included 1311 patients. The mean age was 47.7 years (s.d.: 9.5) and the median age was 50.2 years. Most of the participants (that is, 85.9%) were women. A total of 372 distinct prescription patterns for vitamin D supplementation were observed. The two most frequent (that is, 32.6% in total) involved a unique dispensation of a high dose of either 200,000 (17.5%) or 100,000 IU (15.1%). Most prescribed supplements were based on vitamin D3 (65%), and the most prescribed forms were high dose ampoules (81.6%). Only 48.9% of the participants were given a maintenance prescription after the initial loading phase.

CONCLUSIONS

Our results reveal a significant variability in the prescriptions for vitamin D supplementation from physicians in the French population. Moreover, less than half of the patients receive maintenance therapy after the initial loading phase of supplementation.

摘要

背景/目的:关于血清 25-羟维生素 D(25(OH)D)水平较低的中年患者(即 20-60 岁)补充维生素 D 的建议,争议不断。我们旨在描述这一年龄组补充维生素 D 的实践情况,因为目前对此知之甚少。

方法

我们对法国罗纳-阿尔卑斯大区的个人详尽报销数据进行了分析。该大区包含超过 600 万居民。数据来源于法国医疗保险系统。我们确定了年龄在 20-60 岁之间、无严重合并症、2008 年 12 月 1 日至 2009 年 1 月 31 日期间进行过 25(OH)D 检测的患者。随后为这些患者开具了维生素 D 处方,我们将其纳入了分析。我们通过频率和日剂量描述了维生素 D 补充模式。

结果

本研究共纳入了 1311 名患者。患者平均年龄为 47.7 岁(标准差:9.5),中位数年龄为 50.2 岁。大多数患者(85.9%)为女性。共观察到 372 种不同的维生素 D 补充处方模式。其中两种最为常见(共占 32.6%),分别为单次给予 20 万(17.5%)或 10 万 IU(15.1%)的高剂量。最常开的补充剂是维生素 D3(65%),最常开的剂型是高剂量安瓿(81.6%)。只有 48.9%的患者在初始负荷阶段后接受了维持治疗。

结论

我们的研究结果表明,法国人群中医生开具的维生素 D 补充处方存在显著差异。此外,在初始补充负荷阶段后,不到一半的患者接受维持治疗。

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